In the season of holiday celebrations, food tends to be a front and center focus. For people with eating disorders, this time of year can be especially unnerving. Eating disorders cause distorted thinking as it relates to the individual’s own body image, coupled with a great desire to lose weight. Bulimia Nervosa is one such disorder where sufferers indulge in overeating that is followed by purging through self-induced vomiting, use of laxatives, diuretics, enemas, extreme exercise and/or fasting.

The intake of abnormally large amounts of food and the purging that follows can be life threatening but can be cured with the appropriate psychological therapy/counseling.

Men and women with eating disorders may not appear as though they are struggling. Eating disordered behaviors are hidden and may not be obvious to family and friends. Since the binge/purge cycles are usually done in secret, this falls especially true for bulimia. Concealing this disorder can continue for several years before anyone may notice or realize exactly what is going on. Because purging does not prevent weight gain, bulimic individuals may not outwardly exhibit physical symptoms that they are suffering from this disorder.

The “control,” a person with bulimia feels while managing their food intake and bodies is extremely difficult to give up and will only get worse with time if help is not accepted. So, if you have a feeling that someone you know is in trouble, please reach out. While it can be a very difficult subject to broach, and the sufferer may be defensive and unwilling to give up their way of coping, know that the conversation you have could be the difference to help them get better.

How do you know if someone is suffering from bulimia? Sometimes it is extremely difficult to tell; however, there are indications that a problem does exist. Here is a list of things that can help you spot when someone you care about needs help.

Red or bloodshot eyes along with a puffy jaw and cheeks ~ If someone is inducing vomiting, the pressure can cause blood vessels to burst.

Scrapes, scars or calluses on hands and fingers ~ Stomach acid from vomiting can cause damage to skins and nails. Also, scraping their hands and fingers along their teeth can leave tell-tale signs on the back of their hands.

How do they smell ~ Because vomiting can leave an odor behind, noticing not only that particular smell along with bad breath due to dry mouth, but also any great amount of masking scent is important. They may try to cover up with large amounts of mints, mouthwash, perfume or cologne.

Dry and cracked lips and skin surrounding mouth/Discolored teeth ~ Constant opening of their mouth in an effort to throw up, along with stomach acids passing over the lips can cause visible distress to the mouth and teeth as well.

Withdrawal or excuses ~ Avoidance when it comes to get-togethers that involve food is a typical coping strategy for bulimics.

Excessive exercise ~ The individual may spend an above average amount of time exercising, sometimes several times daily and/or for very long periods of time.

Pay attention to bathroom bathroom habits ~ Does the person use the bathroom immediately after eating? Do they run a lot of water (to cover up the sounds of vomiting)? Do they flush the toilet several times?

Eating schedules are erratic ~ Following a specific meal pattern that involves solid meals and snacks isn’t something that bulimic sufferers will endure. A schedule that involves their own control is likely to prevail.

Listen to signs of body image distortion/obsession over looks ~ Comments like “I look/feel fat.” “I always look awful.”, or a focus on “how pretty” tremendously thin models are can be an indication that the person does not have a grasp of what healthy really means.

Body contact discontinues ~ For people in a relationship, touching and intimacy may end due to shame and discomfort with emotions.

Keep in mind that there is no right or wrong way to talk to a person you think might be suffering from an eating disorder. As long as you approach them with genuine concern and kindness in an environment where they won’t feel threatened, telling them openly how you feel is a fair way to proceed. Remember to use statements that begin with “I” vs. statements they may feel are judgemental (“you”) toward them. Encourage them to talk about how they feel as you actively listen without criticism. Remind them that they are not alone and actively persuade them to seek professional help.